Rubella Immunity in Pregnant Iranian Women: A Systematic Review and Meta-Analysis

Introduction and Objectives: Rubella infection within the first trimester of pregnancy may lead to adverse pregnancy outcomes. The present study was conducted to evaluate the immunity against rubella among the pregnant Iranian women. Materials and Methods: The steps of meta-analyses were conducted based on the MOOSE protocol and reported according to the PRISMA guidelines. To review the associated English and Persian literature, a comprehensive search was conducted among the international databases such as Scopus, PubMed/Medline, Science Direct, Embase, Cochrane library, Web of Science and Google Scholar search engine as well as Iranian databases, until April 1, 2018 using the following medical subject headings (MeSH) keywords: ‘Pregnant’, ‘Gestational’,‘Complications of pregnancy’,‘Rubella infection’, ‘Prevalence, ‘Epidemiology’, ‘Immunity’, ‘Immunization’, ‘Antibody’, ‘Immunogenicity’ and ‘Iran’. Cochran’s Q test and I2 index were used to investigate heterogeneity in the studies. Random effects model and fixed effects model were respectively used to estimate the rate of rubella immunity and the effect of different variables on immunity against rubella. The obtained data were analyzed using Comprehensive Meta-Analysis Ver.2. Results: Fifteen studies constituting 7,601 pregnant Iranian women met the inclusion criteria. The overall pooled rubella immunity rate was 90.1% [95% confidence interval (CI): 86.1-93.1]. Rubella immunity rates were respectively 88.6% (95% CI: 80.6-93.6) and 91.5% (95% CI: 88.1-93.9) before and after national vaccine program. Rubella immunity rates were 91.4% (95% CI: 87.8-94.0) and 87.2% (95% CI: 74.3-94.1) based on the enzyme-linked immunosorbent assay (ELISA) and haemagglutination-inhibition (HAI) methods, respectively. There was no significant association between rubella immunity and vaccination program (P=0.398), diagnostic methods (P=0.355), geographic regions (P=0.286), quality of the studies (P=0.286), occupation (P=P=0.751), residence (P=0.801), and year of the studies (P=0.164), but it was significantly associated with age (P<0.001). Conclusion: Despite high rubella immunity among the pregnant Iranian women, anti-rubella antibody screening is recommended for all women of childbearing age.

کلیدواژه ها:

Immunity ، Iran ، Meta-Analysis ، Pregnant Women ، Rubella